Rising co-payments coincide with unwanted effects on continuity of healthcare for patients with schizophrenia in the Netherlands
Autoři:
Arnold P. M. van der Lee aff001; Lieuwe de Haan aff002; Aartjan T. F. Beekman aff001
Působiště autorů:
Department Psychiatry Amsterdam University Medical Centre–location VUmc, Amsterdam, The Netherlands
aff001; Department Psychiatry Amsterdam University Medical Centre–location AMC, Amsterdam, The Netherlands
aff002
Vyšlo v časopise:
PLoS ONE 14(9)
Kategorie:
Research Article
prolekare.web.journal.doi_sk:
https://doi.org/10.1371/journal.pone.0222046
Souhrn
Background
Co-payments, used to control rising costs of healthcare, may lead to disruption of appropriate outpatient care and to increases in acute crisis treatment or hospital admission in patients with schizophrenia. An abrupt rise in co-payments in 2012 in the Netherlands offered a natural experiment to study the effects of co-payments on continuity of healthcare in schizophrenia.
Methods
Retrospective longitudinal registry-based cohort study. Outcome measures were (i) continuity of elective (planned) psychiatric care (outpatient care and/or antipsychotic medication); (ii) acute psychiatric care (crisis treatment and hospital admission); and (iii) somatic care per quarter of the years 2009–2014.
Results
10 911 patients with schizophrenia were included. During the six-year follow-up period the level of elective psychiatric outpatient care (-20%); and acute psychiatric care (-37%) decreased. Treatment restricted to antipsychotic medication (without concurrent outpatient psychiatric care) increased (67%). The use of somatic care also increased (24%). Use of acute psychiatric care was highest in quarters when only antipsychotic medication was received. The majority (59%) of patients received continuous elective psychiatric care in 2009–2014. Patients receiving continuous care needed only half the acute psychiatric care needed by patients not in continuous care. On top of these trends time series analysis (ARIMA) showed that the abrupt rise in co-payments from 2012 onwards coincided with significant increases in stand-alone treatment with antipsychotic medication and acute psychiatric care.
Conclusions
The use of psychiatric care decreased substantially among a cohort of patients with schizophrenia. The high rise in co-payments from 2012 onwards coincided with significant increases in stand-alone treatment with antipsychotic medication and acute psychiatric care.
Klíčová slova:
Social sciences – People and places – Geographical locations – Europe – Medicine and health sciences – Health care – Health economics – Patients – Economics – Pharmacology – Pharmaceutics – Drug therapy – Drugs – Mental health and psychiatry – Health care policy – Outpatients – European Union – Health insurance – Antipsychotics – Schizophrenia – Netherlands
Zdroje
1. Wiersma D, Nienhuis F, Slooff C, Giel R. Natural course of schizophrenic disorders: a 15-year followup of a Dutch incidence cohort. Schizophrenia bulletin. 1998;24: 75–85. doi: 10.1093/oxfordjournals.schbul.a033315 9502547
2. Brown S, Barraclough B, Inskip H. Causes of the excess mortality of schizophrenia. The British Journal of Psychiatry. 2000; doi: 10.1192/bjp.177.3.212 11040880
3. Saha s, Chant D, McGrath J. A Systematic Review of Mortality in Schizophrenia Is the Differential Mortality Gap Worsening Over Time? Archives of General Psychiatry. 2007;64: 1123–1131. doi: 10.1001/archpsyc.64.10.1123 17909124
4. McGrath J, Saha S, Chant D, Welham J. Schizophrenia: A Concise Overview of Incidence, Prevalence, and Mortality. Epidemiologic Reviews. 2008;30: 67–76. doi: 10.1093/epirev/mxn001 18480098
5. Tiihonen J, Lönnqvist J, Wahlbeck K, Klaukka T, Niskanen L, Tanskanen A, et al. 11-year follow-up of mortality in patients with schizophrenia: a population-based cohort study (FIN11 study). The Lancet. 2009;374: 620–627. doi: 10.1016/S0140-6736(09)60742-X
6. Viron M, Stern T. The impact of serious mental illness on health and healthcare. Psychosomatics. 2010; 458–465. Available: http://www.sciencedirect.com/science/article/pii/S0033318210707374
7. Termorshuizen F, Wierdsma AI, Visser E, Drukker M, Sytema S, Laan W, et al. Psychosis and suicide risk by ethnic origin and history of migration in the Netherlands. Schizophrenia Research. 2012;138: 268–273. doi: 10.1016/j.schres.2012.03.035 22521494
8. Almeida OP, Hankey GJ, Yeap BB, Golledge J, Norman PE, Flicker L. Mortality among People with Severe Mental Disorders Who Reach Old Age: A Longitudinal Study of a Community-Representative Sample of 37892 Men. PLoS ONE. 2014;9: e111882. doi: 10.1371/journal.pone.0111882 25360781
9. Correll CU, Detraux J, Lepeleire J, Hert M. Effects of antipsychotics, antidepressants and mood stabilizers on risk for physical diseases in people with schizophrenia, depression and bipolar disorder. World Psychiatry. 2015;14: 119–136. doi: 10.1002/wps.20204 26043321
10. Hoertel N, Limosin F, Leleu H. Poor longitudinal continuity of care is associated with an increased mortality rate among patients with mental disorders: Results from the French National Health Insurance Reimbursement Database. European Psychiatry. 29: 358–364. doi: 10.1016/j.eurpsy.2013.12.001 24439514
11. Wagner E, Austin B, Korff VM. Organizing care for patients with chronic illness. The Milbank quarterly. 1996;74: 511–44. 8941260
12. Johnson S, Prosser D, Bindman J, Szmukler G. Continuity of care for the severely mentally ill: concepts and measures. Soc Psychiatry Psychiatr Epidemiol. 1997; doi: 10.1007/BF00794612
13. Drake RE, Goldman HH, Leff SH, Lehman AF, Dixon L, Mueser KT, et al. Implementing Evidence-Based Practices in Routine Mental Health Service Settings. Psychiatric Services. 2001;52: 179–182. doi: 10.1176/appi.ps.52.2.179 11157115
14. Crawford MJ, de Jonge E, Freeman GK, Weaver T. Providing continuity of care for people with severe mental illness. Social Psychiatry and Psychiatric Epidemiology. 2004;39: 265–272. doi: 10.1007/s00127-004-0732-x 15085327
15. Falloon IR, Montero I, Sungur M, Mastroeni A, Malm U, Economou M, et al. Implementation of evidence-based treatment for schizophrenic disorders: two-year outcome of an international field trial of optimal treatment. World psychiatry: official journal of the World Psychiatric Association (WPA). 2004;3.
16. Morken G, Widen JH, Grawe RW. Non-adherence to antipsychotic medication, relapse and rehospitalisation in recent-onset schizophrenia. BMC Psychiatry. 2008;8: 32. doi: 10.1186/1471-244X-8-32 18447935
17. Drake R, Bond G, Essock. Implementing evidence-based practices for people with schizophrenia. Schizophrenia Bulletin. 2009; Available: http://schizophreniabulletin.oxfordjournals.org/content/35/4/704.short
18. Kreyenbuhl J, Nossel IR, Dixon LB. Disengagement From Mental Health Treatment Among Individuals With Schizophrenia and Strategies for Facilitating Connections to Care: A Review of the Literature. Schizophrenia Bulletin. 2009;35: 696–703. doi: 10.1093/schbul/sbp046 19491314
19. Burns T, Catty J, White S, Clement S. Continuity of care in mental health: understanding and measuring a complex phenomenon. Psychol Med. 2009;39: 313. doi: 10.1017/S0033291708003747 18570700
20. Walraven C, Oake N, Jennings A, Forster AJ. The association between continuity of care and outcomes: a systematic and critical review. Journal of Evaluation in Clinical Practice. 2010;16: 947–956. doi: 10.1111/j.1365-2753.2009.01235.x 20553366
21. Laan W, van der Does Y, Sezgi B, Smeets H, Stolker J, Wit N, et al. Low Treatment Adherence with Antipsychotics is Associated with Relapse in Psychotic Disorders within Six Months after Discharge. Pharmacopsychiatry. 2010;43: 221–224. doi: 10.1055/s-0030-1254090 20503150
22. Barkhof E, Meijer CJ, de Sonneville LMJ, Linszen DH, de Haan L. Interventions to improve adherence to antipsychotic medication in patients with schizophrenia–A review of the past decade. European Psychiatry. 2012;27: 9–18. doi: 10.1016/j.eurpsy.2011.02.005 21561742
23. Tenback D, Pijl B, Smeets H, van Os J, van Harten P. All-Cause Mortality and Medication Risk Factors in Schizophrenia: A Prospective Cohort Study. Journal of Clinical Psychopharmacology. 2012; doi: 10.1097/jcp.0b013e31823f3c43 22198442
24. Fontanella CA, Guada J, Phillips G, Ranbom L, Fortney JC. Individual and Contextual-Level Factors Associated with Continuity of Care for Adults with Schizophrenia. Administration and Policy in Mental Health and Mental Health Services Research. 2014;41: 572–587. doi: 10.1007/s10488-013-0500-x 23689992
25. Olfson M, Wall M, Wang S, Crystal S, Liu S-M, Gerhard T, et al. Short-term Suicide Risk After Psychiatric Hospital Discharge. JAMA Psychiatry. 2016;73: 1119–1126. doi: 10.1001/jamapsychiatry.2016.2035 27654151
26. Sareen J, Jagdeo A, Cox BJ, Clara I, ten Have M, Belik S-L, et al. Perceived barriers to mental health service utilization in the United States, Ontario, and the Netherlands. Psychiatric services (Washington, DC). 2007;58: 357–64.
27. Schäfer W, Kroneman M, Boerma W. The Netherlands: health system review. Health systems in Transition. 2010;12: 1–229. Available: dare.uva.nl
28. Daley C, Gubb J, Clarke E, Bidgood E. Healthcare Systems: The Netherlands. London: Civitas Health Unit. 2013;
29. Westra D, Wilbers G, Angeli F. Stuck in the middle? A perspective on ongoing pro-competitive reforms in Dutch mental health care. Health Policy. 2016; doi: 10.1016/j.healthpol.2016.02.014 26994866
30. OECD, EU. Health at a Glance: Europe 2016. 2016; doi: 10.1787/9789264265592-en
31. Ministry of Health, Welfare and Sport. Healthcare in the Netherlands. 2016; Available: https://www.government.nl/documents/leaflets/2016/02/09/healthcare-in-the-netherlands
32. Lee A, Haan L, Beekman A. Schizophrenia in the Netherlands: continuity of care with better quality of care for less medical costs. PloS one. 2016;11: e0157150. doi: 10.1371/journal.pone.0157150 27275609
33. Frank RG, McGuire TG. Economics and mental health. Handbook of health economics. 2000;1: 893–954.
34. Osborn R, Squires D, ty M, Sarnak DO, Schneider EC. In new survey of eleven countries, US adults still struggle with access to and affordability of health care. Health Affairs. 2016;35: 2327–2336. doi: 10.1377/hlthaff.2016.1088 27856648
35. Papanicolas I, Woskie LR, Jha AK. Health Care Spending in the United States and Other High-Income Countries. JAMA. 2018;319: 1024–1039. doi: 10.1001/jama.2018.1150 29536101
36. Ven W, Schut FT. Universal mandatory health insurance in the Netherlands: a model for the United States? Health Affairs. 2008;27: 771–781. doi: 10.1377/hlthaff.27.3.771 18474971
37. Ministry of public health, welfare and sport. Vaststelling van de begrotingsstaten van het Ministerie van Volksgezondheid, Welzijn en Sport (XV1) voor het jaar 2012. kst-33000-XVI-1. 2011; Available: https://zoek.officielebekendmakingen.nl/kst-33000-XVI-1
38. Ministry of Public Health, Welfare and Sport. Factsheet maatregelen curatieve GGZ [Internet]. 2011. Available: https://www.rijksoverheid.nl/documenten/brochures/2011/12/08/factsheet-maatregelen-curatieve-ggz
39. Free for all?: lessons from the RAND health insurance experiment. Harvard University Press. 1993;
40. Chandra A, Gruber J, McKnight R. Patient Cost Sharing in Low Income Populations. American Economic Review. 2010;100: 303–308. doi: 10.1257/aer.100.2.303 29517877
41. Chandra A, Gruber J, McKnight R. The impact of patient cost-sharing on low-income populations: Evidence from Massachusetts. Journal of Health Economics. 2014;33: 57–66. doi: 10.1016/j.jhealeco.2013.10.008 24287175
42. Cummings JR, Allen L, Clennon J, Ji X, Druss BG. Geographic Access to Specialty Mental Health Care Across High- and Low-Income US Communities. JAMA Psychiatry. 2017; doi: 10.1001/jamapsychiatry.2017.0303 28384733
43. Couwenberg C. Crossing the bridge. A national action plan to improve care of severe mental illness Summary [Internet]. kenniscentrum Phrenos. kenniscentrum Phrenos; 2014. Available: http://www.kenniscentrumphrenos.nl/wp-content/uploads/2014/12/English-summary.pdf
44. Ravesteijn B, Schachar EB, Beekman AT, Janssen RT, Jeurissen PP. Association of Cost Sharing With Mental Health Care Use, Involuntary Commitment, and Acute Care. JAMA Psychiatry. 2017; doi: 10.1001/jamapsychiatry.2017.1847 28724129
45. Nesvåg R, Jönsson EG, Bakken I, Knudsen G, Bjella TD, Reichborn-Kjennerud T, et al. The quality of severe mental disorder diagnoses in a national health registry as compared to research diagnoses based on structured interview. BMC Psychiatry. 2017;17: 93. doi: 10.1186/s12888-017-1256-8 28292279
46. NZA. Marktscan GGZ 2014 en beleidsbrief-deel A [Internet]. 2014. Available: https://puc.overheid.nl/nza/doc/PUC_3229_22
47. NZA. Marktscan ggz 2015 deel_A, 24-05-16 [Internet]. 2016. Available: https://puc.overheid.nl/doc/PUC_3443_22
48. Box G, Jenkins G. Time series analysis: forecasting and control, revised edition. Holden Day. Holden Day; 1976.
49. Helfenstein U. Box-Jenkins modelling in medical research. Statistical Methods in Medical Research. 1996;5: 3–22. doi: 10.1177/096228029600500102 8743076
50. Sernyak MJ, Rosenheck RA. Antipsychotic Use in the Treatment of Outpatients With Schizophrenia in the VA From Fiscal Years 1999 to 2006. Psychiatric Services. 2008;59: 567–569. doi: 10.1176/ps.2008.59.5.567 18451019
51. Chung W. Psychiatric inpatient expenditures and public health insurance programmes: analysis of a national database covering the entire South Korean population. BMC Health Services Research. 2010;10: 263. doi: 10.1186/1472-6963-10-263 20819235
52. Smeets H, de Wit NJ, Hoes AW. Routine health insurance data for scientific research: potential and limitations of the Agis Health Database. Journal of Clinical Epidemiology. 2011;64: 424–430. doi: 10.1016/j.jclinepi.2010.04.023 20800994
53. Raucher-Chéné D, Hoertel N, Béra-Potelle C, Terrien S, Barrière S, Rin D, et al. Mental healthcare in older adults with schizophrenia: results from 118 French public psychiatric departments. International Psychogeriatrics. 2015;27: 1749–1750. doi: 10.1017/S1041610215001064 26144544
54. Pennington M, McCrone P. Does Non-Adherence Increase Treatment Costs in Schizophrenia? PharmacoEconomics. 2018;36: 941–955. doi: 10.1007/s40273-018-0652-3 29700755
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